Clearing the Dust-Off <i>Abiotrophia defectiva</i>
Bibliographic record
Abstract
Abiotrophia defectiva (ABI), a nutritional variant Streptococcus (NVS), is an uncommon cause of infective endocarditis (IE) involving both native and prosthetic heart valves. Due to the fastidious nature and special nutritional requirements, contribution of ABI to IE had been underestimated. Here we describe a case of Abiotrophia spp. native valve endocarditis in a 40-year-old female intravenous drug user who did not have any other potential source of infection. Blood cultures grew ABI along with Acinetobacter spp. perhaps from licking the needle before injecting. Transesophageal echocardiogram showed mobile vegetations attached to tricuspid and mitral valves. Susceptibility testing is important due to underlying differences in susceptibility to both penicillin and ceftriaxone between ABI and other genera of NVS, though both antibiotics are recommended alternate empiric first-line therapies along with synergistic gentamicin use in accordance with established guidelines to treat NVS endocarditis. She was successfully treated with intravenous ceftriaxone and gentamicin for 6 weeks with clinical and echocardiographic resolution of IE. This case highlights the importance of modern microbial techniques and equipment for accurate and rapid identification of challenging pathogens. J Med Cases. 2019;10(9):277-279 doi: https://doi.org/10.14740/jmc3348
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".